The invention relates to a clip for use in surgical procedures and an apparatus for fitting the clip.
In the medical field a plurality of clips of various shapes are known as well as apparatus for fitting the clips. Such a clip is disclosed, for example, in U.S. Pat. No. 4,498,476. The clip described therein which serves for clamping off blood vessels consists of an upper clip portion and a lower clip portion which are interconnected symmetrically by a resiliently flexible bridge portion. At the end opposite the bridge portion the upper clip portion is provided with an opening adapted to catch a pin projecting from the lower clip portion. In some embodiments the pin is provided with a roof- or arrow-like point. The pin and the point cooperate with the opening to serve as locking elements for closing the pin. In the closed position of the clip the upper and lower portions of the clip are in contact with one another. However, the edges of tissue cannot be engaged by such a clip.
DE 30 34 356 A1 discloses a surgical clamp particularly for clamping blood vessels which also consists of an upper and a lower part which are interconnected symmetrically by a resiliently flexible bridge structure. The upper portion has an opening formed therein at the end opposite the bridge structure and a ratchet projecting from the lower portion is adapted to be received in the opening. At one side the ratchet is provided with teeth by means of which the clamp can be closed and locked. But also with this clamp, edges of tissue cannot be engaged.
In German UM G 83 29 725 a microclip for medical applications is described which consists of an elastically deformable material and which comprises a U-shaped member with portions extending from the free ends of the legs of the U backward to the center of the U in parallel linear relation with the legs and which are characterized in that the parallel portions are disposed at a small distance from the legs of the U and are in contact with the legs only near their point of connection with the free legs of the U. The microclip preferably consists of soft elastic stainless steel. The free ends of the U-shaped member may have openings for engagement by a clip handling instrument. This microclip is also designed mainly for clamping blood vessels. For the engagement of the edges of tissue after surgical incisions it appears to be not particularly suitable.
A further surgical microclip is described in EP 04 32 743 A1. This microclip includes two oppositely disposed flanges of sheet metal. The flanges have at one end edge portions with pointed projections directed toward one another and, at the opposite end, they have operating areas which can be compressed against the force of a spring. The microclip is formed as a one-piece structure and includes a resiliently elastic connecting flange disposed between the operating areas.
Since this microclip is apparently to be mounted by hand it needs to be relatively large and, therefore, is not suitable for internal surgery and particularly not for minimally invasive surgery.
DE 31 39 488 C2 discloses an aneurysm-clip which comprises two legs which are pivotally joined to, and cross, one another and which serve to fix tissue. The legs are compressed by a double-coiled spring wire which is connected to both legs.
A similar clip is disclosed in DE 35 23 031 A1. In this clip the double-coil spring wire is replaced by a hub comprising two hub sections which are joined by a pin so as to be rotatable relative to one another.
The two last-mentioned clips are suitable particularly for the temporary pinching of blood vessels; they are not suitable for the permanent fixing of tissue edges after incisions.
DE 30 28 259 A1 discloses a tube litigation pistol by which clips for the interruption of vessels can be mounted. The apparatus is suitable for clips whose upper and lower portions are mounted on an axis so as to be pivotal relative to one another and which can be fixed by a spring.
A clip mounting plier is known from DE 40 24 636 A1. This clip mounting plier comprises a tube which is axially movable by means of two handle halves. At the distal end of the tube there are two jaws which can be closed or opened by a rope extending through the tube. The tube consists of a hose-like elastic sleeve which remains in position during movement of the rope. The clip mounting plier obviously serves for the mounting of aneurysm clips.
A further plier for mounting of a styptic clamp is described in DE 40 15 562 A1. This plier is provided at its distal end with two jaws which are operable by operating handles at the proximal end via an operating rod extending through a tube. The operating rod is hollow and serves as a magazine for receiving a number of clips. However this plier is designed for mounting only U-shaped clips.
It is the object of the present invention to provide a clip and a clip applicator for mounting such a clip by means of which, during minimal invasive surgery, after lesions and incisions the edges of tissue can be placed together and fixed through an access sleeve.